louisiana’s hepatitis c elimination plan07-2017 ssp legislation 8-2017 integrated hiv/std with...
TRANSCRIPT
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Louisiana’s Hepatitis C Elimination Plan
Samuel Burgess, MA, MSHCM
Deputy DirectorLouisiana Department of HealthOffice of Public HealthSTD/HIV/Hepatitis Program
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Public Health Crisis Caused by Hepatitis C
• 40,263 persons reported with a HCV diagnosis from 2007 to 2017.1
• Louisiana has high rates of liver and bile duct cancers driven by both HBV and HCV.2
• 5th highest rate (10.1 per 100,000 population) of liver and bile duct cancers • 3rd for rate (8.4 per 100,000 population) of death from liver and bile duct cancers
• Estimated 112,424 Louisianans3 at very high risk for acquiring HCV through injection drug use.4
• Costly per-patient treatment price severely limits access.
References:1 Louisiana HCV Surveillance Data, 20172 National Cancer Institute. State Cancer Profiles: Incidence Rate Report of Liver & Bile Duct Cancer, 20153 2017 U.S Census Bureau4 Tempalski et al., 2013; Oster et al., 2015; Lansky et al., 2014
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Chronic Hepatitis C Cases - Louisiana, 2017
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Chronic Hepatitis C Diagnosis Trends –Louisiana, 2008-2017
0.0
20.0
40.0
60.0
80.0
100.0
120.0
140.0
160.0
180.0
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Diag
nosis
Rat
e (p
er 1
00,0
00)
No.
Rep
orte
d Ca
ses
HCV Diagnoses
HCV Rates
7
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NewHepatitisCDiagnosisAgeDistribution– Louisiana
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PWIDBaby Boomers
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Big Bet: Louisiana will eliminate Hepatitis C as a public health problem
5
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2019 Establish Hepatitis C subscription model
2020 Treat 10,000 Louisianans in Medicaid and Corrections
2021 Expand access to all Louisianans with private payers
2022 Reduce prevalence to 33% of 2018 level
Louisiana HCV Elimination Goals
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5
01-2017CDC
Determination of Need for SSP
07-2017 SSP Legislation
8-2017Integrated HIV/STD
with Viral Hepatitis
10-2017Expanded ADAP to cover all
HCV meds
11-2017Joined HCV
Medicaid Affinity Group
5-2018
Updated Louisiana Medicaid
Prior Authoriza
tion
07-2018Developed Elimination Blueprint
10-2018Sponsored National
Harm Reduction
Conference
02-2019ASTHO
Eliminating
Hepatitis Grant
07-2019Launch
DAA Subscriptio
n Model
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The Hepatitis C Elimination Program
1. Implement Hepatitis C Treatment Subscription Model for Medicaid and
Corrections Populations – 5 year contract with Gilead’s Asegua Therapeutics for
unlimited access to Epclusa, starting July 2019
2. Expand Provider Capacity to Treat Hepatitis C - Train primary care providers to
diagnose and treat hepatitis C and refer for advanced liver disease, cancer, and
substance use disorders;
3. Educate Public on Availability of Cure and Need for Screening - Mobilize high-
risk populations for screening and treatment through media campaign;
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The Hepatitis C Elimination Program Continued… 4. Strengthen HCV Surveillance to Link Persons Previously Diagnosed to
Treatment - Upgrade LDH’s hepatitis C surveillance system to support timely identification of infected individuals;
5. Expand HCV Screening and Expedited Linkage to Care - Partner with health care providers across the State to screen high-risk populations and ensure individuals with hepatitis C are linked to treating providers;
6. Implement Harm Reduction and Complementary Prevention Strategies -Prevent new or reinfections through syringe service programs and treatment for opioid use disorder;
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Acknowledgements – Louisiana’s HCV Elimination Team
Rebekah Gee, MDAlexander Billioux, MDBeth Scalco, LCSW, MPADeAnn Gruber, PhDWilliam Robinson, PhDJessica Fridge, MPHKim Hood, JDEmilia Myers, MPH
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Questions/Comments
Samuel Burgess, MA, [email protected]
mailto:[email protected]